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Search: (WFRF:(Olesen J)) srt2:(2020-2024) > (2021) > Persistence and adh...

Persistence and adherence to non-vitamin K antagonist oral anticoagulant treatment in patients with atrial fibrillation across five Western European countries

Komen, Joris J (author)
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands;Department of Healthcare Development, Stockholm Region, Public Healthcare Services Committee, Stockholm, Sweden
Pottegård, Anton (author)
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
Mantel-Teeuwisse, Aukje K (author)
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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Forslund, Tomas (author)
Karolinska Institutet,Department of Healthcare Development, Stockholm Region, Public Healthcare Services Committee, Stockholm, Sweden;Department of Medicine Solna, Clinical Epidemiology/Clinical Pharmacology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
Hjemdahl, Paul (author)
Karolinska Institutet,Department of Medicine Solna, Clinical Epidemiology/Clinical Pharmacology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
Wettermark, Björn (author)
Karolinska Institutet,Uppsala universitet,Institutionen för farmaci,Pharmacoepidemiology
Hellfritzsch, Maja (author)
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark;Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark
Hallas, Jesper (author)
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
Olesen, Morten (author)
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
Bennie, Marion (author)
Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK;Public Health and Intelligence Strategic Business Unit, NHS National Services Scotland, Glasgow, UK
Mueller, Tanja (author)
Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
Voss, Annemarie (author)
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
Schink, Tania (author)
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
Haug, Ulrike (author)
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany;Faculty of Human and Life Sciences, University of Bremen, Bremen, Germany
Kollhorst, Bianca (author)
Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
Karlstad, Øystein (author)
Chronic Diseases and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
Kjerpeseth, Lars J (author)
Chronic Diseases and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
Klungel, Olaf H (author)
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands;Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
Karlstad, O (author)
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 (creator_code:org_t)
2021-06-07
2021
English.
In: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 23:11, s. 1722-1730
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • AimsTo assess persistence and adherence to non-vitamin K antagonist oral anticoagulant (NOAC) treatment in patients with atrial fibrillation (AF) in five Western European healthcare settings.Methods and resultsWe conducted a multi-country observational cohort study, including 559 445 AF patients initiating NOAC therapy from Stockholm (Sweden), Denmark, Scotland, Norway, and Germany between 2011 and 2018. Patients were followed from their first prescription until they switched to a vitamin K antagonist, emigrated, died, or the end of follow-up. We measured persistence and adherence over time and defined adequate adherence as medication possession rate ≥90% among persistent patients only.ResultsOverall, persistence declined to 82% after 1 year and to 63% after 5 years. When including restarters of NOAC treatment, 85% of the patients were treated with NOACs after 5 years. The proportion of patients with adequate adherence remained above 80% throughout follow-up. Persistence and adherence were similar between countries and was higher in patients starting treatment in later years. Both first year persistence and adherence were lower with dabigatran (persistence: 77%, adherence: 65%) compared with apixaban (86% and 75%) and rivaroxaban (83% and 75%) and were statistically lower after adjusting for patient characteristics. Adherence and persistence with dabigatran remained lower throughout follow-up.ConclusionPersistence and adherence were high among NOAC users in five Western European healthcare settings and increased in later years. Dabigatran use was associated with slightly lower persistence and adherence compared with apixaban and rivaroxaban.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Physiology (medical)
Cardiology and Cardiovascular Medicine

Publication and Content Type

ref (subject category)
art (subject category)

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